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9.4 Local initiatives

Breastfeeding in public

Baby Friendly Point 6

Point 6 of the Seven-point Plan for Sustaining Breastfeeding in the Community states:
Provide a welcoming atmosphere for breastfeeding families

The health care facility should welcome breastfeeding in all public areas and this should be indicated by appropriately worded signs. Suitable facilities should be available for mothers who prefer to feed in privacy.

Reception staff should be aware that mothers are welcome to breastfeed in all public areas and be able to describe how they would advise a mother who wished to feed in privacy.

The normal act of breastfeeding seen in public

Australia now has a law passed in Federal Parliament under the Sex Discrimination Act which makes it illegal for anyone to discriminate against breastfeeding mothers!

Does your community health unit make it explicitly clear that breastfeeding is welcomed in all public areas? Do you have an area set aside should a mother prefer to breastfeed in privacy?


© Australian Breastfeeding Association


© BFI UK Breastfeeding Welcome


Take a walk

Go for a walk around your hospital or community health centre. Are there obvious signs in all the public areas making it clear that mothers may breastfeed in any them, AND referring her to a private area should she prefer it?

If not design your own signs and display them until the organisation develops 'official' signs.

Supporting mothers in the community

Baby Friendly Step 10 and Point 7

Step 10 of the Ten Steps to Successful Breastfeeding, and Point 7 of the Seven-point Plan for Sustaining Breastfeeding in the Community state:
Step 10: Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Point 7: Promote co-operation between health care staff, breastfeeding support groups and the local community.

A Cochrane database systematic review 1 on the effect of lay health workers in the community found them to be "promising" in breastfeeding promotion. Attendance at mother-to-mother support groups or follow-up by peer counsellors has demonstrated significant increases in maintaining exclusive breastfeeding. 2 The peer counsellor role is unique from a health professional role in that it brings a mother together with another mother - the experienced can share with the new, the new can be supported and learn from the experienced.

A report on the effects of implementation of the Baby Friendly Hospital Initiative (BFHI) and community postnatal support on breastfeeding rates indicated an increase in breastfeeding initiation to one month of age in the BFHI group compared to the control.3 However, once breastfeeding support groups activity increased, breastfeeding at 6 months and 12 months was significantly increased. They concluded that activities aiming to promote breastfeeding in maternity hospitals had limited success on long-term breastfeeding. For far-reaching effect postnatal support is also required.

Workbook Activity 9.5

Complete Activity 9.5 in your workbook.

UK Baby Friendly requires Community Health Units to address each of the following to meet the requirements of this point.

  • All breastfeeding mothers should know which professional(s) to contact for breastfeeding support and how to access this help.
  • All breastfeeding mothers should know how to contact a breastfeeding counsellor or support group for help with breastfeeding.
  • All breastfeeding mothers should know how to access help with breastfeeding outside surgery/office hours.
  • Relevant staff should be able to describe a procedure which ensures that information on the progress of breastfeeding is passed on during the handover of care between midwife and health visitor.
  • Mothers should demonstrate an awareness that such a procedure exists.

What procedures does your unit have in place to meet this standard?

How is the availability of professional support and peer support communicated to mothers? Do you have a method of recording that mothers have received this information? How does your Unit encourage mothers to attend peer support organisations? If you are unsure of this could you form a group to look at what is done now, improve the procedure if necessary, and ensure the procedure is communicated to all staff at your Unit?

If applicable, what handover procedures are in place between the birthing service and the community service?

Peer support in unusual circumstances

As a sign of the changing times Gribble (2001)4 found that Internet breastfeeding support groups can provide mother-to-mother support to those breastfeeding in unusual circumstances.

Consider forming a small group to research online support groups with the goal being to produce reference material for staff when counselling a mother whose situation may be unique (eg. adoptive breastfeeding, breastfeeding after reduction mammaplasty, etc). Contacting the facilitator of the group to determine their goals and the way the group functions would help to determine if their goals are consistent with those of your organisation.

You can't do it alone!

Peer support offers mothers a different type of support to what she receives from health professionals. Both are needed by mothers and, working together, both will help her to give her baby the healthiest start in life.

Engage the peer breastfeeding support organisations in your community.

Engaging the Community

Each year the World Alliance for Breastfeeding Action (WABA) promotes World Breastfeeding Week. World Breastfeeding Week (WBW) is the greatest outreach vehicle for the breastfeeding movement, being celebrated in over 120 countries. Officially it is celebrated from 1-7 August. However, groups may choose other dates to make it a more successful event in their countries.

Each year a theme is chosen and WABA produces resource materials to assist groups and individuals to celebrate this event, raising community and media awareness of breastfeeding. This is an ideal opportunity for your Unit to celebrate breastfeeding and use the occasion to educate your community about breastfeeding.

You will be able to get ideas and download resources from their website when they become available: ExternalWABA World Breastfeeding Week.


Logo for WBW 2007

Logo for WBW 2007

Logo for WBW 2010

Logo for WBW 2010


Have fun this year!

Start now! Get a group together to plan activities and promotions (of breastfeeding and your wonderful unit!) during Breastfeeding Awareness Week. The theme for this year is very modern and topical.

There are lots of resources available on the Internet and you could think up many others. Don't forget to involve the media in your celebrations.

What should I remember?

  • Breastfeeding is a normal act which needs to be seen by everyone.
  • The importance of welcoming breastfeeding mothers in public areas.
  • How breastfeeding support groups play a vital role in continued support for breastfeeding mothers.
  • That there are opportunities to become involved in breastfeeding promotion on a personal and professional level.

Self-test quiz

Assessment Quiz

When you are happy that you've understood all the information in this topic you will be ready to complete the Module 9 Assessment. To do this, go to the course opening page, scroll down to the Assessment section and choose Module 9.

Notes

  1. # Lewin SA et al. (2005) Lay health workers in primary and community health care.
  2. # Hoddinott P et al. (2006) Effectiveness of a breastfeeding peer coaching intervention in rural Scotland
  3. # Bosnjak AP et al. (2004) The effect of baby friendly hospital initiative and postnatal support on breastfeeding rates - Croatian experience
  4. # Gribble KD (2001) Mother-to-mother support for women breastfeeding in unusual circumstances: a new method for an old model.